Abstract:AIM: To evaluate the efficacy of riboflavin administration and ultraviolet A(UVA)cross-linking on advanced symptomatic bullous keratopathy.

METHODS: Fifteen patients with symptomatic pseudophakic bullous keratopathy(PBK)were included. Slit-lamp examination, visual acuity, foreign body sensation(FBS)questionnaire, corneal clarity grading, ocular pain intensity scale and corneal thickness measures with Pentacam and ultrasound pachymetry(UP), were performed before corneal cross-linking and 1 and 6mo thereafter. After using sodium chloride solution, for one week, the central 8mm(diameter)of the corneal epithelium was removed, and cross-linking, with riboflavin instillation every 3min for 30min, and UVA irradiation for 30min was performed.

RESULTS: Five males and 10 females with mean age of 66±13y were included. Mean follow up time was 6.2mo. Corneal transparency in all eyes was statistically significantly better 1 month after treatment than preoperatively(P<0.05). At 6mo, however, corneal transparency was better in 8 eyes, the same in 5 eyes, and worse in 2 eyes compared with preoperative levels(P= 0.218). Foreign body sensation subsided in 70% of patients. The average CCT decreased within 1mo after the procedure(P<0.05). At 6mo, all but 3 eyes had progressive swelling, and the CCT increased; however, the CCT was still statistically significantly thinner than preoperatively(P=0.006). The improvement in mean CDVA from preoperatively to 1mo postoperatively was statistically significant(P=0.010). At 6mo, no significant differences were observed(P=0.130). The pain scores at 1mo were statistically significantly better than preoperatively(P=0.007). At 6mo, however the mean pain score was higher than at 1mo and not statistically significantly different from the preoperative score(P=0.070).

CONCLUSION: Corneal CXL significantly improved corneal transparency, corneal thickness, and ocular pain 1 month postoperatively. However, it did not seem to have a long-lasting effect in decreasing pain and maintaining corneal transparency in patients with PBK. This procedure extends the time interval for corneal transplantation and increases visualization at DSAEK procedure.

Abstract:AIM: To evaluate associations between the grades of age related macular degeneration(AMD)and serum levels of antioxidant vitamins(vitamin A, C and E)and smoking.

METHODS: Fifty-three AMD patients and 31 individuals having ages matching with the patient group were enrolled the study. Colored fundus photographs of the macula were used to place participants(n=84)into one of the five groups(Grade I-V)based on the frequency and severity of the lesions associated with AMD. Serum antioxidant vitamin levels were measured using High Performance Liquid Chromatography(HPLC). Smoking status was classified as non-smoker, ex-smoker and current smoker. Total number of packs smoked per year, was defined.

RESULTS: The distribution of vitamin A, E, and C levels were 0.874±0.326mg/L, 10.739±4.874mg/L, 1.737±0.447mg/L in control group and 0.880±0.305mg/L, 9.487±6.060mg/L, 1.870±2.191mg/L in AMD group, respectively. The difference between AMD and control group was not statistically significant for vitamin A, E and C levels(P>0.05). There were no significant differences between subgroups of AMD for vitamin A(P=0.881)and vitamin E(P=0.293)but there was a contradicting rise of vitamin C levels(P=0.044)with increasing levels of the disease. There were no significant differences between AMD and control group regarding smoking status, but there was a significant difference for total number of packs smoked per year(P=0.02). An increase of number of total packs smoked per year was determined along with the rising grade of AMD(P=0.007).

CONCLUSION: We found no relation between AMD and serum levels of vitamin A and E but vitamin C levels was increase with AMD grades unexpectedly. We found dose-response relationship between smoking and AMD.

Abstract:AIM: To compare the efficacy of intravitreal ranibizumab and bevacizumab for the treatment of neovascular age-related macular degeneration(AMD)using a pro re nata(PRN)treatment regimen.

METHODS: A total of 63 eyes(35 eyes treated with ranibizumab and 28 eyes treated with bevacizumab)of 63 patients with newly diagnosed neovascular AMD were analyzed and compared retrospectively. Outcomes included comparison of best-corrected visual acuity(BCVA)and central foveal thickness(CFT)after ranibizumab or bevacizumab treatment at 12mo follow-up. Two-tailed t-tests and one-way ANOVA were used to compare mean changes in BCVA and CFT for different groups.

RESULTS: Thirty-five eyes treated with ranibizumab and 28 eyes treated with bevacizumab were enrolled and completed 12mo follow-up. At 12mo, mean BCVA increased by 0.1logMAR with ranibizumab treatment; however BCVA decreased by 0.06logMAR with bevacizumab treatment(P=0.01). A gain of at least 0.3logMAR in BCVA was observed in 13 eyes(37%)treated with ranibizumab and in 4 eyes(14%)treated with bevacizumab. Mean CFT reduced by 41.6μm and 8.1μm in the ranibizumab and bevacizumab groups, respectively(P=0.003). The mean number of injections per eye was 4.46 with ranibizumab and 4.11 with bevacizumab(P>0.05).

CONCLUSION: Intravitreal ranibizumab yielded better visual and anatomical results than bevacizumab. However, randomized long-term clinical trials are needed to draw conclusions about efficacy and safety of the two drugs.

Abstract:AIM: To describe causes, characteristics and parental consanguineous marriage of low vision patients referred to our clinic for taking low vision aids in Turkey.

METHODS: We conducted a retrospective study of 236 low vision patients who visited to our clinics in Istanbul from 2009 to 2013. Age and sex distribution, cause of low vision, parental consanguineous marriage, type of prescribed low vision aids, and changes of the visions were reviewed. In this retrospective study, visual acuity was classified based on best-corrected visual acuity in the better eye according to the World Health Organization definition(blindness, visual acuity(VA)<20/400; severe visual impairment, VA<20/200-20/400; mild to moderate visual impairment, VA<20/60-20/200). The causes of blindness and low vision were determined using the 10th version of International Classification of Diseases based on the main cause in both eyes. Vision aids were prescribed based on visual acuity and patients' requirements. To describe data, we used mean±SD and frequency.

RESULTS: The study included 236 patients, 65% male, with a mean age of 38.5±24.2 years(range, 6 to 95year). In result, male were more than female. The age group between 15 and 30-year-old(35.6%)was the largest age group. Mild to moderate visual impairment, severe visual impairment and blindness were present in 122(51.6%), 84(35.6%)and 30(12.7%)of the patients, respectively. Choroid and retina diseases(62.7%)were main causes of low vision. Elderly low vision patients macular degeneration is becoming a leading cause of low vision(61.3%). The causes of visual impairment were retinal and choroidal diseases(62.7%), nystagmus(23.7%), optic nerve and optic tract diseases(11%), congenital cataract(0.8%), and glaucoma(1.7%). Eighty-eight(37.3%)patients Galilean type; 116(49.2%)patients keplerian type telescopic glasses recommended. Eighteen(7.6%)patients had no improvement in visual acuity with low vision aids(LVA). Forteen patients(5.9%)were approved the magnifier for near vision. In most patients, the use of LVA is improved both near and distance visual function. Parental consanguinity is present in 62(26.3%)patients, most commonly between the ages of 15-30 were significantly higher in the group(50%).

CONCLUSION: Diseases of the retina and choroid are the main cause over 14 years old groups, nistagmus is the most common cause under 15 years old group of visual impairment among patients referred to our clinic in Turkey. Parental consanquinity was significantly higher in macular dystrophy and retinitis pigmentosa groups. Of genetics in the etiology of these diseases are known to be effective. For this reason, parental consanguineous marriage is a big problem still in Turkey.

Abstract:AIM:To investigate the protective effects of pEGFP/ Ang-1 transfected BMSCs on RF/6A in condition of high glucose concentration.

METHODS: BMSCs were transfected pEGFP/Ang-1, confirming by observation of enhanced green fluorescent protein(EGFP)with fluorescence microscope. Rhesus chorioido-retinal endothelial cells(RF/6A)were cultured with or without pEGFP/Ang-1 transfected BMSCs in transwell under high glucose concentration. Three days after co-cultured, cell vitality and pPKB expression of RF/6A were detected with methyl thiazolyl tetrazolium(MTT)methods and Western blot respectively.

RESULTS: EGFP was expressed in BMSCs successfully transfected with pEGFP/Ang-1. RF/6A co-cultured with pEGFP/Ang-1 transfected BMSCs showed higher viability and pPKB expression compared with RF/6A cultured in condition of high glucose concentration cultured with or without untransfected BMSCs(P<0.01 respectively), showing no difference to control group(P> 0.05 respectively).

CONCLUSION: pEGFP/Ang-1 transfected BMSCs showed protective effects, may via PKB, on RF/6A in condition of high glucose concentration.

Abstract:AIM: To investigate the effect of 17-allylamio-17-demethoxygeldanamycin(17-AAG), an heat shock protein 90(Hsp90)inhibitor, on the expression of integrin- linked kinase(ILK)induced by hypoxia in retinal pigment epithelium(RPE)cells.

METHODS: RPE cells were cultured with 200μmol/L cobalt chloride(CoCl₂)for 12 hours to imitate chemical hypoxia. Pretreatment of 17-AAG was 1 hour prior to hypoxic insult. Experiment was divided into hypoxic control group, Dimethyl sulfoxide(DMSO)control group and 17-AAG pretreatment group(0.01, 0.10, 0.50, 1.00, 5.00 and 10.00μmol/L). RT-PCR and Western blot analysis were used to examine the expression of ILK in cultured RPE cells.

RESULTS: The density ratios of ILK mRNA and β-actin mRNA of hypoxic control group, DMSO control group and 17-AAG pretreatment groups were 1.32±0.04,1.29±0.03,0.93±0.06,0.70±0.05,0.53±0.03,0.44±0.04,0.32±0.04,0.30±0.03; and the density ratios of ILK protein and β-actin protein were 2.16±0.04, 2.13±0.04, 1.65±0.04, 1.13±0.05, 0.74±0.03, 0.41±0.06, 0.35±0.04, 0.35±0.03. The ILK expression in 17-AAG pretreated groups were inhibited compared to hypoxic control group(P < 0.05), and the decrease was in concentration-dependent manner.

CONCLUSION: Hsp90 inhibitor 17-AAG was effective to inhibit the expression of ILK induced by hypoxia in RPE cells.

Abstract:AIM:To investigate the expression levels and correlation of VEGF and MMP-9 in the retinal ischemia/reperfusion injury(RIRI).

METHODS: Eighty-four Wistar rats were divided into normal control group and at 6h, 12h, 24h, 48h, 3d and 7d group after retinal ischemia/reperfusion. The model of RIRI was constructed by elevating the intraocular pressure. The expression levels of VEGF and MMP-9 was measured using immunohistochemical staining.

RESULTS: No VEGF positive cells were found in normal group and it began to express at 12h, increased gradually and reached maximal levels at 48h after RIRI. MMP-9 positive expression was rarely detected in the normal control group and began to increase at 6h, reached the peak at 24h. There was statistical difference between normal control group and ischemia/reperfusion group(P<0.01)with regard to the expression of VEGF and MMP-9.The expression of VEGF was positively correlated to MMP-9(P<0.05).

CONCLUSION: The high expression of VEGF and MMP-9 is significantly correlated with RIRI and may play an important role in the occurrence and development of retinal ischemic injury.

Abstract:AIM: To analysis the curative effect of two kinds of trabeculectomy for glaucoma.

METHODS: Totally 300 cases(384 eyes)of glaucoma patients in our hospital from May, 2006 to September, 2011 were randomly divided into observation group 160 cases(200 eyes)and control group 140 cases(184 eyes), treated with combined trabeculectomy and traditional trabeculectomy, respectively. Two groups of curative effect were compared, and they were followed up for 1y.

RESULTS: All operations are completed smoothly. At postoperative 1wk, observation group(combined trabeculectomy)and control group(traditional trabeculectomy)in incidence of shallow anterior chamber were 7.5% and 21.7%. The difference was statistically significant(P<0.05). Surgical success rate was 90.0% after 1y in observation group which was obviously higher than 65.2% in the control group(P<0.05); one year postoperatively, functional follicular formation rate of the observation group and the control group were 86.0% and 63.0%, respectively, and the differences had statistical significance(P<0.05); the incidence of postoperative complications of observation group was obviously lower than that in the control group(P<0.05).

CONCLUSION: Combined trabeculectomy for glaucoma receives better curative effect than that of traditional trabeculectomy, and can effectively reduce the occurrence of postoperative shallow anterior chamber, the functional filtering bleb formation as well as long-term success rate of surgery is distinct, and complication is low. Thus, it is suitable for clinical promotion.

Abstract:AIM: To observe and analyze the change situation of hemorheology, Aβ, β-EP, Hcy and ocular hemodynamics indexes of patients with glaucoma.

METHODS: Sixty patients with glaucoma in our hospital from November 2011 to October 2013 were the observation group, 60 healthy people were the control group, then the hemorheology, Aβ, β-EP, Hcy and ocular hemodynamics indexes of two groups were detected and compared, then the detection levels of patients with different Richardson stages were compared.

RESULTS: The hemorheology, Aβ, β-EP, Hcy and RI of observation group were all significantly higher than those of control group, and the PSV and EDV were obviously lower than those of control group, the fluctuation of patients with higher Richardson stages were all bigger than those of patients with lower Richardson stages,all P<0.05, there were all significant differences between those comparison indexes.

CONCLUSION: The change of hemorheology, Aβ, β-EP, Hcy and ocular hemodynamics indexes of patients with glaucoma are great, and the blood supply of patients with higher stages are worse, and the serum related indexes were higher.

Abstract:AIM:To investigate the expression levels of stroma cell-derived factor-l(SDF-1)and vascular endothelial growth factor(VEGF)in tissue of pterygium and to evaluate the effect of glucocorticoid on the expression of SDF-1.

METHODS: Fourty-eight eyes of pterygium were recruited, and 24 of them were chosen randomly to use 0.2g/L fluorometholone eyedrops for a week before surgery. The expressions of SDF-1 and VEGF were detected by immunohistochemistry in pterygium and normal conjunctival tissue. The software IPP was applied to the quantitative determination of the optical density of SDF-1 and VEGF.

RESULTS: SDF-1 and VEGF only had expression or no expression in the basal layer of epithelial cells in normal conjunctiva, but expressed in the whole layer of epithelial cells and vascular endothelial cells in pterygium. Differences in expression levels between them were statistically significant. The expression of VEGF and SDF-1 in pterygium presented a significant correlation(r=0.5235, P<0.01). The expression levels of SDF-1 and VEGF in pterygium was significantly decreased after using glucocorticoid, thus there was statistic difference.

CONCLUSION:Both SDF-1 and VEGF have important links with the development of pterygium. Glucocorticoid may inhibit neovascularization through decreasing expression levels of SDF-1 and VEGF.

Abstract:Corneal transparence and thickness mostly depend on corneal endothelial cells. The shortage of transplant-grade donor corneal tissues and limited in vitro expansion of human corneal endothelial cells prompted further impetus for the development of tissue-engineered human corneal endothelium reconstructed in vitro. The culture method of human corneal endothelial cell has been widely used. The standard used to evaluate and identify the human corneal endothelial cells cultivated in vitro has not been established. The objective of this article is to summarize the further study on identification and cultivation of human corneal endothelial cell in vitro.

Abstract:Cornea is one of the important structure for the eye. It is transparent and locats about 1/6 before fiber membrane. Collagen arrangement is orderly and lets the light through. Because of the special arrangement of collagen, it makes transparent state. Thus it can be seen the important role of corneal collagen. Now we reviewed the distribution of collagen, physiological function, changes of corneal collagen cross-linking, clinical use and security as follows.

Abstract:Femtosecond laser-assisted cataract surgery performs the anterior capsulotomy, lens fragmentation, corneal incisions making and astigmatic limbal relaxing incision with femtosecond laser, which effectively reduces the complications of conventional phacoemulsification surgery and improves the postoperative visual quality of patients. It further improves the technology and effect of cataract surgery and has broad clinical application prospects. This paper compares pros and cons as well as the clinical values of femtosecond laser-assisted cataract surgery with conventional phacoemulsification surgery based on the overview of published articles.

Abstract:Advances in spectral-domain optical coherence tomography(SD-OCT)technology provide improved monitoring of progression and assistance in quantifying response to treatment modalities in neovascular age-related macular degeneration(NVAMD). There is little doubt that anti-vascular endothelial growth factor(anti-VEGF)drug therapy is becoming a new approach to the management of NVAMD, while long-term follow-up and necessary retreatments are the key issues to remain obtained visual acuity.SD-OCT imaging helps to identify early recurrence of choroidal neovascularization during treatment with anti-VEGF. This review discusses the present applications of the commercially available SD-OCT systems in the follow-up of after the injection of intravitreal anti-VEGF in NVAMD.

Abstract:Very small embryonic-like stem cells(VSELs)is a rare population of pluripotent adult stem cells, whose biological nature is similar to that of embryonic stem cells, firstly identified in murine bone marrow(BM)and human cord blood(CB)by Kucia and his group in University of Louisville. They have similar outlook to embryonic stem cells such as cell morphology and markers and similar inner pluripotent characteristics which make them be the most potential seed cells in the cell replacement therapy. In this review, we will focus on research advance about VSELs and clinical significance in the stem cell transplantation treatment of retinal degenerative diseases.

Abstract:Amblyopia is one of the common pediatric ophthalmology disease at present. It causes serious harm to children's visual development, which is characterized in the eye without obvious organic disease. However, functional factors can cause the distance vision ≤0.8 that can not be corrected. In this paper, it focuses on reviewing the current research advances and therapy of amblyopia children, so as to provide a powerful evidence for the better treatment of amblyopia children.

Abstract:RNA interference is an important discovery in the field of biology in recent years, which is a gene silencing phenomena of specific sequences induced by double-stranded RNA. RNAi technology becomes perfect and mature increasingly, and has been gradually applied in functional genomics, regulatory mechanisms of gene expression research areas.As an effective tool, RNAi technology in gene therapy of eye disease has also made great progress.This paper briefly reviews the current researches of RNAi technology adopting in corneal endolthelial cells injury and therapies of cataract, glaucoma, neovascular diseases and proliferative vitreoretinopathy.

Abstract:AIM: To explore the application of Pentacam excimer laser epithelial keratomileusis(LASEK)and excimer laser in situ keratomileusis(LASIK)after the changes of posterior corneal surface height.

METHODS: Retrospective analysis of clinical data of 100 patients with myopia by using LASEK and LASIK for the treatment of the 50 patients(100 eyes)in our hospital from January 2013 to June 2013, surface height changes after preoperative and postoperative 3 months were compared by measuring Pentacam corneal analysis system.

RESULTS: Three months after operation, the LASEK posterior corneal surface height was 7.4±5.0mm, significantly higher than 5.6±3.4mm before operation, LASIK posterior corneal surface height was 7.5±5.1mm, significantly higher than 5.5±3.5mm before operation, the differences were statistically significant(P<0.05); 6 months after surgery, two methods of corneal surface height obtained was 1.74±3.67mm and 1.80±3.61mm, there was no significant difference(P>0.05).

CONCLUSION: LASEK and LASIK on corneal posterior surface forward, LASIK is slightly obvious in early period.

Abstract:AIM: To research the curative effect analysis of two kinds of small incision surgery treating senile cataract patients.

METHODS: Totally 71 senile cataract patients(123 eyes), aged from 76 years to 96 years, were selected as the research objects. All 55 eyes were all treated with small incision non-phacoemulsification(group A), and 68 eyes were treated with phacoemulsification(group B), and then both received intraocular lens implantation.

RESULTS: The postoperative visual acuity of the patients between the two groups was no significant difference(P>0.05). There were 42 eyes in group A and 54 eyes in group B which suffered from corneal edema. There was no significant difference in the number of corneal edema of grade Ⅰ, grade Ⅱ and grade Ⅲ between the two groups(Chi-square =0.81, P>0.81). The ratio of corneal edema of grade Ⅲ in group A was less than that in group B. The corneal edema after surgery in patients of group A was with faster fading time than that in group B, and the eyes of corneal edema in group A fading at 1d postoperatively were more than that in group B(Chi-square=6.45, P<0.05). Endothelial cell counts in group A and group B were(2 341+238)/mm² and(2 181+282)/mm², respectively, and there was no significant difference between the two groups(P>0.05). Group A was with a low complication rate.

CONCLUSION: Small incision non-phacoemulsification treating senile cataract patients can get a good result for postoperative visual acuity recovery and correction, and it is safe and effective. It receives the similar curative effect with phacoemulsification, but takes less expense. It is worthy of clinical and wide application.

Abstract:AIM: To investigate the efficacy of Mitomycin C(MMC)for patients with refractory glaucoma and its influence on the serum vitamin and interleukin.

METHODS: Patients with refractory glaucoma from January 2010 to January 2013 were randomly divided into control group(compound trabeculectomy treatment group)with 80 cases and observation group(MMC combined with compound trabeculectomy treatment group)with 80 cases, then the difference in efficacy between the two groups were counted, and the intraocular pressure, visual acuity and the levels of FA, VB12, VB6, IL-2 and IL-6 of two groups before and after the treatment were also been compared.

RESULTS: The surgical success rate of observation group was 80.9% which was significantly higher than that of control group(60.7%); after the surgery, the intraocular pressure of observation group were all lower than that of control group, and the visual acuity was better than that of control group, all P<0.05. The levels of FA, VB12, IL-2 and IL-6 of failed surgery group were significantly lower than that of control group and successful surgery group(P<0.05). The levels of FA, VB12, IL-2 and IL-6 of observation group at 3mo after the treatment were all higher than those indexes of control group,all P<0.05.

CONCLUSION: Combined with MMC could effectively improve surgical success rate of refractory glaucoma, and improve the indicators of serum vitamin, interleukin.

Abstract:AIM: To report the influences onfoveal thickness and corneal edema after torsional phacoemulsification.

METHODS: Totally 52 patients(52 eyes)with age-related cataract were randomly assigned to phacoemulsification using torsional mode(26 eyes)or conventional ultrasound mode(26 eyes). The foveal thickness examined by optical coherence tomography(OCT)after surgery at 1, 4 and 12wk and corneal edema was examined by slit lamp after surgery at 1d.

RESULTS: The postoperative averagefoveal thickness datas of the two groups, comparing with corresponding preoperative datas, were significantly augmented at 1, 4 and 12wk(P<0.05); the difference of foveal thickness was obviously augmented at 1wk postoperatively(P<0.05), was no obvious differences at 4 and 12wk(P>0.05). The effects of corneal edema in torsional group were slighter(P<0.05).

CONCLUSION: The postoperative influences onfoveal thickness and corneal edema with torsional mode are slighter than that with ultrasound mode, and the postoperative reactions with torsional mode are efficiently reduced.

Abstract:AIM: To investigate the relationship between the macular retinal thickness and diopter, dominant eye, axial length.

METHODS: Totally 128 patients with high myopia group 180 eyes were selected, including the dominant eye in 79 eyes, the non dominant eye in 101 eyes. OCT was applied to measure macular and peripheral retinal thickness and A-mode ultrasonic diagnostic equipment to axial length. Another 112 patients with emmetropia group in 180 eyes, including the dominant eye in 106 eyes and the non dominant eye in 74 eyes served as control. Obtained data were statistically analyzed.

RESULTS: The average length of ocular axis in patients with high myopia(29.57±1.57)mm were significantly prolonged, compared with the mean axial length in normal group(24.13±0.90)mm(P<0.05). The length of ocular axis and the retinal thickness of foveal inner ring area(from the foveal region of 1-3mm)above(S₁), below(I₁), temporal(T₁)and foveal outer ring area(from the foveal region of 3-6mm)above(S₂), below(I₂), nasal(N₂), temporal(T₂)existed correlation, while there was no correlation with macular central and nasal foveal inner ring area(N₁)retinal thickness. The retinal thickness of macular central area and each partition in high myopia group were obviously thinner than emmetropia group(P<0.05). There was no statistical significance(P>0.05)between dominant and non dominant eye macular retinal thickness in high myopia.

CONCLUSION: The detected values of high myopia macular retinal thickness by OCT are lower than emmetropia group. There is a negative correlation between the ocular axial length and macular retinal thickness above(S₁), below(I₁), temporal(T₁), above(S₂), below(I₂), nasal(N₂), temporal(T₂)with high myopia. Ocular dominance and non dominant eye macular retinal thickness with high myopia have no obviously difference.

Abstract:AIM: To evaluate clinical effect of vitrectomy combined with retinal photocoagulation for proliferative diabetic retinopathy(PDR).

METHODS:A retrospective analysis 72 patients(104 eyes)with PDR who underwent vitrectomy, postoperative fundus fluorescein angiography and retinal photocoagulation within 4wk, from July 2009 to November 2012 in our hospital. All the patients were followed up for more than 12mo, analysising the clinical data of preoperative, postoperative, final corrected vision and the operation complications.

RESULTS:The increasing rate of visual acuity after retinal photocoagulation(the last retinal photocoagulation)within 1wk was 88.5%(92/104), 1mo was 92.3%(96/104), 3mo was 90.4%(94/104)and one eye had neovascular glaucoma, 6mo was 88.5%(92/104)and one eye had retinal detachment, 12mo was 80.8%(84/104)and 2 eyes with silicone oil emulsification. Along with the development of diabetic retinopathy, the increasing rate of visual acuity declined, complications of silicone oil eye operation increased, especially in eyes with proliferative diabetic retinopathy in phase five or six.

CONCLUSION:Vitrectomy combined with retinal photocoagulation in treatment of PDR is effective and safe. Postoperative fundus fluorescein angiography can have a definite object in view of retinal photocoagulation after vitrectomy, which can reduce excessive photocoagulation and prevent light coagulation deficiencies, while improve the visual acuity effectively and reduce the complications.

Abstract:AIM:To investigate the characteristics of the retinal nerve fibre layer(RNFL)thickness in myopia measured by Cirrus HD optical coherence tomography(OCT), and the relationship between RNFL thickness and refractive diopter/axial length.

METHODS: Totally 106 cases(196 eyes)were divided into low, moderate and high myopia group and 38 cases(60 eyes)as normal group were included in the study. Cirrus HD OCT was used to measure the RNFL thickness. Each eye was performed circular scans around the optic nerve with a circle size of 3.46mm. The average RNFL thickness, the mean RNFL thickness in each quadrant and clock hour in each group were recorded. The difference between each myopia group and normal group and the relationship between RNFL thickness and refractive diopter was researched.

RESULTS: Compared to normal group, the average RNFL thickness, the mean RNFL thickness of superior and inferior were thinner in myopia groups, the difference between moderate, high myopia group and normal group were significant(P<0.05), the nasal quadrant RNFL thickness was also thinner, but the difference was not significant(P>0.05), the temporal quadrant RNFL thickness was thicker and the difference was significant(P<0.05); Compared to normal group, at 2:00, 6:00, 12:00 position, the RNFL thickness decreased significantly in each myopia group(P<0.05); at 8:00, 9:00, 10:00 position, the RNFL thickness increased significantly(P<0.05); at 1:00, 5:00 position in moderate, high myopia group, the RNFL thickness decreased significantly(P<0.05).

CONCLUSION: The average RNFL thickness and the RNFL thickness at superior quadrant, inferior quadrant, 2:00, 6:00, 12:00 position in myopia groups are thinner than normal group; the RNFL thickness at temporal quadrant, 8:00, 9:00 and 10:00 position are thicker. The result shows the characteristics of the RNFL thickness in myopia, which is of instructive significance to guide the diagnosis of disease. Effect of refractive diopter on RNFL should be concerned for a clinical diagnosis; The RNFL thickness at 7:00, 8:00, 10:00 and 11:00 position in myopia group are not thinner than normal group. If they become thinner, glaucoma should be considered.

Abstract:AIM:To analyze the low energy laser photocoagulation under treatment of central serous chorioretinopathy(CSC)correlation of clinical effect and visual acuity with leakage location.

METHODS:Using low energy laser on the leakage point in the parafoveal and 53 cases of central serous chorioretinopathy patients underwent laser closed, drug treatment group and 33 cases as control. Comparison of two groups was observed before and after treatment in patients with symptoms, ocular fundus, fundus fluorescein angiography(FFA)changes, fundus optical coherence tomography technology(OCT)examination, visual acuity improved in degree, and the relationship between the cure rate, relapse rate. All 126 cases were associated with visual leakage location analysis.

RESULTS:The cure rate of lasercomparison: 4 weeks after operation, the cure rate was 92.5%. The drug therapy group at 4 weeks after treatment cure rate was 30.3%.The two groups were compared(P<0.01), and there was significant difference. The laser group and treatment group after treatment in 2 weeks, 4 weeks, in March June, and there was significant difference(P<0.01). The medicine group the recurrence rate was 12.1%, the lasertreatment group and recurrence rate was 11.3%. The two groups were compared, no significant difference(P>0.05). Nonparametriccorrelation analysis method to compare the relationship between visual acuity and fluorescence leakage point location, the correlation coefficient(r=0.216, P=0.0001), there is a positive linear correlation between.

CONCLUSION:The leakage point in the parafoveal outside in early stagelaser in the treatment of low energy laser, can shorten the course of disease, improve the cure rate of visual acuity and clinical, and improve the visual quality, but can not reduce the recurrence rate. There is a positive correlation between visual acuity and leakage location, clinicalguidance for prognosis and treatment.

Abstract:AIM: To observe the image features of punctate inner choroiditis(PIC)at different stages by optical coherence tomography(OCT).

METHODS: A retrospective analysis was performed on 24 PIC patients(33 eyes)with the median age of 29 years old(range: 16-47), where 19 cases were female(79.2%). Among the 24 cases, 9 cases were bilateral onset(37.5%)and 19 cases were with myopia(79.2%). All of the patients were given fundus fluorescein angiography(FFA)and optical coherence tomography(OCT). Through OCT, patients with PIC at different stages were observed for morphology of outer plexiform layer(OPL)and outer nuclear layer(ONL), integrity of inside and outside connections of visual cells(IS/OS), integrity and morphology of reflective tape on retinal pigment epithelium(RPE), and light reflection intensity of choroid and sclera.

RESULTS: The results showed that during active stage and atrophic stage of PIC, there were excavation of ONL and OPL towards thechoroid, weakened or partially disappeared reflective tape of IS/OS, interrupted or fuzzy reflective tape of RPE, hillock-like protrusion of RPE towards the ONL or ONL with medium to high reflection, and strengthened reflection of choroid and sclera under the lesion partly. The rates of the above performances in active stage were 9.1%, 100%, 100%, 86.4% and 77.3%, respectively, and in recovery stage, the corresponding rates were 81.8%, 90.1%, 81.8%, 45.5%, and 90.1%. Medium to high reflection of the protrusion under ONL was more commonly seen in active stage, with P<0.05; while depression towards OPL and ONL was more commonly seen in atrophic stage, with P<0.05.

CONCLUSION: There are both common points and differences of OCT features in PIC at active stage and atrophic stage, suggesting the injury and repair pathological process of outer neural epithelium, retinal pigment epithelium and innerchoroid inflammatory.

Abstract:AIM: To explore the efficacy of fibrin glue with bandage contact lens for pain relief after pterygium surgery performed with limbal autograft transplantation.

METHODS: A prospective clinical trial was carried out in 52 patients(72 eyes)operated for primary nasal pterygium. All patients were randomly divided into the fibrin glue with bandage contact lens group(experimental group, 28 cases, 38 eyes)and suture group(control group, 24 cases, 34 eyes). Autologous limbal graft taken from the superotemporal limbus was used to cover the sclera after pterygium excision under local anesthesia with 20g/L lidocaine. In experimental group, the transplant was attached to the sclera with fibrin tissue adhesive and in control group with 10-0 Virgin silk sutures. Experimental group weared bandage contact lens after surgery while the control group did not. The degree of pain after surgery was evaluated at 1, 2, 3, 5 and 7d after surgery. Follow-up was 6mo, matching degree of graft and complication such as infection, relapse, implant healing badness and subconjunctival cyst were mainly observed and recorded.

RESULTS: The pain index scores of the experimental group were significantly less than those of control group(all P=0.000). In observation period, all conjunctival autografts in both groups were successfully attached and were intact without falling off, dissolution or recurrence and there were no complications such as infection, relapse, implant healing badness and subconjunctival cyst.

CONCLUSION: Fibrin glue with bandage contact lens could significantly release pain response afterpterygium excision surgery.

Abstract:AIM: To evaluate changes in tear function and corneal staining in patients who underwent laser in situ keratomileusis(LASIK)using two different femtosecond lasers.

METHODS:Forty eyes underwent FS200 and 40 eyes underwent VisuMax. The tear film break-up time(TBUT), Schirmer I test(SⅠt)and fluorescein staining were assessed preoperatively at 1wk; 1 and 3mo postoperatively. The analysis of variance(ANOVA)for repeat measurements or Kruskal—Wallis ranks test were used. For the differences between FS200 and VisuMax-operated eyes, a independent-samples t test or Wilcoxon matched-samples rank sum test were used.

RESULTS: There were no statistical differences in any clinical outcome measure between the two kinds of lasers(P<0.05), although there was a trend towards slightly reductions for TBUT in FS200-operated eyes. TBUT of the two groups eyes showed the same reductions(F=100.37, P<0.01; F=112.25, P<0.01)when compared preoperative levels to 1wk; 1 and 3mo postoperatively levels. Moreover, there were obvious decreases of the Schirmer Ⅰ test were observed on any visit after the operation for both groups(F=42.15, P<0.01; F=37.27, P<0.01). Furthermore, corneal staining was significantly increased at 1wk postoperatively(FS200 Z=4.88, P<0.01; VisuMax Z=4.28, P<0.01)after LASIK compared to preoperative conditions, and recovered to the level of preoperative at 1mo postoperatively.

CONCLUSION: This study shows that changes in TBUT,Schirmer I test and corneal staining are statistically similar in LASIK using FS200 and VisuMax femtosecond lasers for flap creation. However, the VisuMax-operated eyes of TBUT after LASIK have faster recovery than in FS200 eyes.

Abstract:AIM: To observe the efficacy of deproteinated extract of calf blood ophthalmic gel with artificial tears local eye drops in treatment of dry eye.

METHODS: A randomized, parallel-control approach was adopted, 150 patients(300 eyes)with dry eye were divided into treatment group and control group equally(75 cases, 150 eyes). The treatment group was applied Dextran and Hypromellose eye drops combined with deproteinated extract of calf blood ophthalmic gel, simply Dextran and Hypromellose eye drops for control group. Clinical symptoms, SchirmerⅠ test(SⅠt), break-up time(BUT), corneal fluorescein staining and tear protein were observed. Therapeutic observation was 3mo.

RESULTS: BUT, SⅠt, and corneal fluorescein staining have statistical significance before and after treatment(P<0.05 or P<0.01), the changes in treatment group were obviously superior to that in control group(P<0.05). The total clinical effect satisfaction rates were 96% for treatment group and 75% for control group, curative effect in treatment group was obviously superior to control group(P<0.05). Tear protein was significantly improved in treatment group(P<0.05).

CONCLUSION: The deproteinated extract of calf blood ophthalmic gel with artificial tears local eye drops perform better than artificial tears eye drops only in treatment of dry eye.

Abstract:AIM: To evaluate the Fuming tablet's clinical therapeutic effect on the recovery of optic nerve function after the retinal detachment surgery.

METHODS: Group control study was performed in 60 cases of retinal detachment surgery in our hospital from Jan 2010 to Jan 2013. According to different treatments, these patients were divided into different group. Thirty patients underwent Fuming tablet treatment(observation group),whereas others received mecobalamin injection treatment(control group). All of these patients were followed-up for 6wk. During these processes, we were recording and analyzing their visual acuity, intraocular pressure, ocular fundus condition and retinal nerve fiber layer thickness(RNFLT).

RESULTS: The effective rate of visual acuity and ocular fundus in observation group were 90% and 97% respectively, and in control group were 77% and 80% respectively. The difference had statistically significance.(P<0.01). Compared with control group, post-treatment a and b wave amplitude of observation group in dark adaptation and light adaptation have significant differences, as well as the difference of a and b wave amplitude in pre-treatment and post-treatment(P<0.05). But intraocular pressure had not significantly statistical differences(P>0.05).

CONCLUSION: Fuming tablet can improve the absorption of fluid under retina after retinal detachment surgery, the recovery of optic nerve and visual function.

Abstract:AIM: To compare the effect of different phacoemulsification incision on postoperative corneal astigmatism for cataract patients.

METHODS: The cataract patients were selected in our hospital. The patients were divided into control group(corneal limbus opposite curved scleral tunnel incision group)and observation group(above the top of cornea or temporal transparent corneal incision group)randomly. At 1wk; 1 and 3mo after surgery, the change of corneal astigmatism and vision of the patients in two groups were compared and analyzed.

RESULTS:Compared with control group, 1wk; 1 and 3mo after surgery, the average corneal astigmatism and surgically induced corneal astigmatism of the patients in observation group were decreased significantly. The visual acuity and corrected visual acuity were increased significantly. There was statistically significant(P<0.05). Compared with control group, the time for the operation of the patients in observation group was shorted significantly, there were statistically significant(P<0.05).

CONCLUSION: Center distance and small incision corneal phacoemulsification can reduce postoperative astigmatism and improve postoperative visual acuity for cataract patients. It provides guarantee for further strengthen the clinical treated effect for cataract patients.

Abstract:AIM: To investigate the changes of corneal curvature after non-phacoemulsification in small-incision cataract surgery with intraocular lens implantation and discuss the essence of iatrogenic astigmatism.

METHODS: In this study, the horizontal corneal curvature(HCC)and vertical corneal curvature(VCC)of 99 patients(116 eyes)were documented before and after cataract surgery,with the postoperative follow-up of 3d; 1, 2wk; 1, 3, 6mo; 1, 2, 3a. The difference value of the HCC and the VCC between preoperation and postoperation were calculated and statistically analyzed.

RESULTS: The VCC was deceased by 2.01D, while the HCC was increased by 1.62D on the 3d after surgery; the difference value of the HCC and VCC were both decreased acutely in the 3mo postoperationly(the difference value of the VCC was -0.52D and HCC was 0.46D); the difference value of the HCC and VCC both were decreased mildly after 3mo of postoperation, There was no significant difference between the difference value of HCC(0.29D)and VCC(-0.29D)at 6mo(P=0.801); VCC was still smaller than that of preoperation(-0.26D), and HCC was larger than that of preoperation(0.25D)at the 3a. Paired t test was performed in these curvature differences, which both decreased apparently from 3d to 6mo after surgery(P<0.001), while they stayed still from 6mo to 3a postoperatively(VCC: P=0.284; HCC:P=1.000).

CONCLUSION: It remains astigmatism for a short time after small-incision cataract surgery and the treatment requires improvement so as to minimize the astigmatism as much as possible.

Abstract:AIM: To investigate the correlation between myopic refractive error and relative factors, including the corneal refractive power, posterior refractive power, axial length, corneal asphericity coefficient Q value, central cornea thickness(CCT)and intraocular pressure(IOP).

METHODS:According to the degree of myopia measured by subjective refraction, 138 myopia patients were divided into three subgroups: mild group(-1.00D--3.00D), moderate group(-3.25D--6.00D), high group(>6.00D). The Pentacam anterior segment tomographer(Germany, Oculus Company)was used to measure the corneal refractive power, posterior refractive power, and corneal asphericity in the right eye. IOP, CCT and axial length were measured by a non-contact tonometer and A-scan ultrasonic, respectively. The data was analyzed with a Pearson correlation analysis and one-way ANOVA.

RESULTS: The myopic refractive error was negatively correlated with the axial length(r=-0.682, P<0.001), but was not correlated with the corneal refractive power(r=0.009, P=0.925). The axial length was negatively correlated with corneal refractive power(r=-0.554, P<0.001). The myopic refractive error was postively correlated with the Q value(r=0.674, P<0.001), which was negatively correlated with the IOP(r=-0.375, P=0.01). There was no significantly correlation between the myopic refractive error and CCT, IOP(r=-0.138, P=0.141; r=-0.121, P=0.157).

CONCLUSION:The corneal refractive power plays the role of emmetropization during the development of myopia. There is clinic significance for the correlation between Q value and refractive error, IOP to guide the corneal refractive surgery.

Abstract:AIM:To improve the efficacy pathological changes of retinal microvessel in the early damp-heat diabetic patients from TCM theory of shuganlizhuo.

METHODS: Totally 56 patients with early damp-heat diabetic, 28 cases in treatment group and another 28 cases in control group. The treatment group treated with shuganlizhuo prescription(Shuhe capsules), the control group with Acarbose, all in a row with three courses. TCM syndrome manifestations, visual acuity, field of vision, as well as 2h postprandial blood glucose(P2HBG)and glycosylated hemoglobin(HbA1c)between the two groups before and after treatment were observed.

RESULTS: The treatment group was able to significantly improve the TCM symptoms(P<0.01), P2HBG, and HbA1c, improved visual acuity(P<0.05), reduced visual field defects MD average values(P<0.01).

CONCLUSION: The method of shuganlizhuo has improved micro lesions of early damp-heat diabetic retinal effects may be related to improve the systemic symptoms.

Abstract:AIM: To understand the prevalence of myopia and to analyze the influencing factors among primary school students in urban area of Lanzhou city, and to provide evidence for prevention and control of myopia.

METHODS: Using the cluster random sampling method, 823 students of two primary schools were selected in urban area of Lanzhou city, which were subsequently performed visual and optometry examination and were asked to fill in questionnaires.

RESULTS: The prevalence rate of myopia in urban area of Lanzhou city was 41.8%. Individual behavior, the time spent on near-work and outdoor activities were the main influencing factors.

CONCLUSION: Primary school should put emphasis on the education of eye caring, and parents should help children distribute the time to reading, entertainment and outdoor activities reasonably, to prevent and slow down the occurrence of myopia.

Abstract:AIM:To investigate the common ocular diseases in school children age of 6 to 14 years old in Cangzhou, Hebei, China and find the relative risk factors.

METHODS:From March 2011 to October 2012, 20 schools including 1 and 6 grade school children were randomly selected as survey venues by Cangzhou Eye Hosipital. Then, 3 150 people as the selected residents were enrolled, which was figured out through the random cluster sampling procedure. Every participant completed questionnaire, and a series of examination. SPSS 16.0 was used for statistical analysis.

RESULTS:Totally 3 150 residents finally took part in this study.(1)There were 2672 eyes suffered lower vision <0.9, and the rate was 42.42%. The prevalence rate of dry eye was 27.24%; The prevalence rate of eye lids margin and conjunctivitis was 22.59%; The prevalence rate of strabismus was 6.00%.(2)The prevalence rate of congenital cataract was 0.13%, The prevalence rate of congenital ptosis was 1.90%, The prevalence rate of Under the eyelid trichiasis was 1.41%; The prevalence rate of congenital inspects tit was 0.0635%。

CONCLUSION:The rate of low vision in school children is higher, among these the rate of myopia is the highest. All these result suggested: Family and community should pay sufficient attention to conduct children's eye health and prepare a balanced behaviour, to prevent the occurrence of ophthalmopathy.

Abstract:AIM: To know the rate of students' myopia in junior school and factors affecting its occurrence in high altitude Tibetan areas in Qinghai, and provide basis for the prevention of myopia.

METHODS: Totally 2 209 junior school students were extracted as respondent with stratified cluster sampling method. The gender, age, ethnicity, grade, eye behavior, physical activity and parental visual conditions were collected by self-made questionnaire, and the curvature of the cornea, anterior chamber depth and axial length were detected.

RESULTS: The prevalence of myopia was 48.02%, including the mild myopia, moderate myopia and high myopia were 40.74%, 35.31% and 23.96% respectively. Curvature of the cornea, anterior chamber depth and axial length had statistical difference between normal vision and different degrees of myopia(P<0.05). The prevalence of myopia had statistical difference in different gender, ethnicity, grade, visual near distance, sitting posture, eye exercises, outdoor activity time each week and the case of parents eyesight(P<0.05). Gender, ethnicity, grade, visual close range, sitting posture, eye exercises, outdoor activity time each week and the case of parents eyesight were the factors affecting the occurrence of myopia by using logistic regression analysis.

CONCLUSION: Incorrect sitting posture, parental myopia, visual near distance <20cm, incorrect eye exercises and less time for outdoor activities are the main reasons that cause myopia of junior students. The effective prevention and controlled measures should be taken for these factors.

Abstract:AIM: To investigate the application of problem based learning(PBL)steered by constructivism.

METHODS: The 120 students were appointed as the routine teaching group and the PBL steered by constructivism group separately, who were coming from the department of clinical medicine and clinical pharmacy in grade 94, China Medical University. They were divided into PBL steered by constructivism group(60 students)and the routine teaching group(60 students). The students' feedbacks and teaching effects were compared by the questionnaire after teaching.

RESULTS: The feedback of the students in the PBL steered by constructivism group were significant better than that in the routine teaching group, including interest, referring data, self-study, thought process, obtaining and spreading knowledge, computer utilization, studying independently, concerted struggling, appreciating and magnanimous ability, discussion and communication(P<0.05).

CONCLUSION: Application of problem based learning steered by constructivism interests the students in Ophthalmologic teaching and is helpful in their self-study, which is benefit to elevate the teaching level and train the qualified scientists.

Abstract:With the change of the concept of graduate enrollment, the recruiting proportion of clinical medicine professional degree graduate students is more and more, and the training of professional degree graduate students is increasingly focusing on practical. In our experience in clinical training for ophthalmology professional degree graduate students, increasing the ward clinical practice time is important. For particular emphasis on the guiding role of the typical cases, each professional group combined their professional characteristics of the typical cases to instruct the graduate students, training their clinical diagnosis and treatment ability, training their microsurgical techniques. From clinical medical writing, record summary, literature review, professional degree graduate students could expand their knowledge structure, practice their thesis writing ability. Based on the typical cases, expansion of knowledge coverage, they could improve the ability of diagnosis and treatment for special disease cases. In this rigorous training system, professional degree graduate students can learn by analogy, and focus on typical cases to get the most intuitive panoramic understanding of the diseases, with a minimum of time to master the most clinical knowledge, to enrich clinical experience, and to lay the foundation for future work in the assessment.

Abstract:AIM:To investigate the main reasons,effects and complications of penetrating keratoplasty.

METHOTS: Retrospective analysis on 150 cases(150 eyes)of penetrating keratoplasty was done from Jan.2011 to June 2013.

RESULTS: Reasons: coneal lecuma 99 eyes(66%); corneal degeneration 18 eyes(12%); corneal ulcers 15 eyes(10%); corneal endothelium decompensation 10 eyes(6.7%); keratoconus 8 eyes(5.3%). Effects: Grafts were transparent in 110 eyes(73.3%). There are 42 eyes(28%)less than or equal to 0.05 in visual acuity,60 eyes(40%)better than 0.05 and less than or equal to 0.3 and 48 eyes(32%)better than 0.3. Complication: The main complication was immune rejection(28 eyes, 18.7%).

CONCLUSION: Penetrating keratoplasty is an important and effective means for keratitis disease.

Abstract:AIM:To investigate the clinical effect of vitrectomy combined with phacoemulsification for treatment of lens dislocation.

METHODS: Ninety-two cases(92 eyes)of lens dislocation were included in the study. Pars plana vitrectomy was used to remove the vitreous base and pars plana. Then phacoemulsification was performed. The postoperative recovery of visual acuity and complications were observed.

RESULTS: The visual acuity increased in all patients, and there was no serious complication.

CONCLUSION: Vitrectomy combined with phacoemulsification is safe and reliable which is worthy for clinical promotion.

Abstract:AIM: To evaluate the clinical effect of surgical treatment on monocular serious cataract with exotropia.

METHODS: Reviewed 45 patients diagnosed as cataract with exotropia who accepted cataract surgery and intraocular lens implantation from Mar. 2010 to Dec. 2012 in our hospital. Preoperatively the visual acuity of 44 patients was<0.05. One 2-year old child couldn't cooperate with the examination. The best-corrected visual acuity(BCVA), fundus, strabismus, binocular single vision(BSV)and diplopia condition were observed postoperative 6 months.

RESULTS: One 2-year old child couldn't cooperate with the examination. The other congenital cataract patient didn't acquire BSV and diplopia. Among 5 middle-aged patients, the BCVA of 3 cases were above 0.6 with normal fundus and BSV, 2 cases were finger count with abnormal fundus and without BSV. Among 38 senile cataract cases, 31 cases acquired BSV, 3 cases without BSV and diplopia, 3 cases appeared diplopia postoperatively and recovered in 6 months, 1 case with exotropia and diplopia accepted triple prism treatment.

CONCLUSION: Most of adult patients with monocular serious cataract andexotropia can acquire normal eye position and BSV.

Abstract:AIM: To evaluate two-hook technique in manual sutureless extracapsular cataract extraction under special position.

METHODS: The clinical data of 25 patients(30 eyes)who were under semireclining position in manual small incision cataract surgery(ECCE)in which the two-hook extraction technique was used, the related complications such as capsule rupture, corneal edema and visual acuity were statistically analyzed.

RESULTS: No eyes experienced posterior capsule rupture, suspensory ligament transaction, vitreous prolapse during surgeries in 25 patients(30 eyes). Posterior chamber intraocular lens were implanted successfully, the visual acuity was improved with different extent. Transient corneal edema was noted in 1 eye and disappeared at 1wk postoperatively. Eighty-five percent have the visual acuity(≥0.5)at 2mo postoperatively.

CONCLUSION: The two-hook technique for nucleus extraction is safe and reliable, of high originality and can be applied in a wider range of indications other than normal cases. The technique is worthy of application in basic medical institutions.

Abstract:AIM: To observe the clinical effect of phacoemulsification with foldable intraocular lens implantation on cataract with angle-closure glaucoma.

METHODS: Twenty-nine cases(29 eyes)of angle-closure glaucoma with cataract underwent phacoemulsification with foldable intraocular lens implantation, and the data of visual acuity, intraocular pressure, gonioscopy and complications after operation were statistically analyzed.

RESULTS:Postoperatively, 28 eyes(96.5%)visual acuity were improved. Intraocular pressure of 25 eyes(86.2%)were maintained at a normal level without any IOP lowering drug, intraocular pressure of 3 eyes(10.3%)were controlled by IOP lowering eye drops, intraocular pressure of 1 eye(3.5%)returned to normal by trabeculectomy. The chamber depth of 29 eyes was increased. 8 eyes were suffered from mild corneal edema, and returned to normal after treatment.

CONCLUSION: Characterized by decreasing intraocular pressure, opening anterior chamber, and raising visual acuity, phacoemulsification with foldable intraocular lens implantation is a good operative therapy for primary angle-closure glaucoma complicated with cataract with preoperative goniosynechia closed ≤270°.

Abstract:AIM: To explore the feasibility and evaluation on prevention of blindness in poverty-stricken region of Yixing led by the People's Hospital.

METHODS: By respectively comparing poverty-relief(hereafter referred to as poverty)patients in poverty-stricken region with the patients in urban district(hereafter referred to as urban)in the following aspects: the situation of visual blindness and the visual disability before surgery and the situation of vision rehabilitation and getting rid of visual disability after operation, and then the differences were analyzed as the standard: blindness was vision less than 0.05, visual disablity was vision less than 0.3 and vision rehabilitation was postoperative vision equal to or more than 0.05 and getting rid of visual disability was postoperative vision equal to or more than 0.3. The differences were compared between the cataract surgery situation in poverty-stricken region led by our hospital and the requirements of “The prevention of blindness project for millions of poor cataract patients” during the twelfth five-year.

RESULTS: There were 72 cases in the poverty group, including 41 cases of blindness and 70 cases of visual disability, while totally 210 cases were in the urban group, including 111 cases of visual blindness and 200 cases of visual disability. There were no difference between the poverty group and urban group in the visual blindness(χ²=1.344, P<0.05)and in the visual disability(χ²=0.146, P<0.05)preoperatively. The rate of vision rehabilitation was 92.7% in poverty group and 88.3% in urban group(χ²=0.236, P<0.05)and there were no difference for vision rehabilitation between the two groups. The rate of vision equal to or more than 0.3 after operation was 78.6% in poverty group and 73% in urban group(χ²=0.846, P<0.05)and there were no difference for vision equal to or more than 0.3 after operation between the two groups.

CONCLUSION: “The prevention of blindness project for millions of poor cataract patients” has been carried out smoothly in our hospital which proves that we do have the ability to undertake the prevention of blindness in our city, but there is still some deficiency to be improved.

Abstract:AIM: To investigate the incidence of posterior capsule opacification(PCO)in congenital cataract cases performed with phacoemulsification combined with double capsulorhexis and dry anterior vitrectomy.

METHODS: Anterior and posterior membrane curvilinear capsulorhexis combined with dry anterior vitrectomy disciplined in phacoemulsification procedures was performed in 18 congenital cataract cases on 32 eyes. Foldable intraocular lens were implanted into capsular bag in 10 cases(16 eyes). The reaction of cornea, anterior chamber inflammation and transparency of were observed, post-op lasting for 6-24mo(mean 15mo).

RESULTS: Transparent cornea and slightly inflammation of anterior chamber were observed in all eyes, while round pupils and transparency of optical axis were remained in most post-op cases. Meanwhile, slightly opacity of optical axis in 3 eyes, mildly pupil displacement in 4 eyes and posterior synechia of iris in 3 eyes were arisen post-operationally as well.

CONCLUSION: Phacoemulsification combined with double capsulorhexis and dry anterior vitrectomy could effectively decrease the incidence rate of PCO and essentially benefit the recovery of post-op visual function in congenital cataract cases.

Abstract:AIM: To research the application of scleral flap suture in trabeculectomy.

METHODS: Totally 114 primary angle-closure glaucoma patients, aged from 36-72 years old, were selected as the objects, and randomly divided into research group and control group. The two groups received different administration methods. Traditional sewing method of sclera flap was used in research group and improved sewing method of sclera flap was used in control group.

RESULTS: There was statistical differences between postoperative intraocular pressure of the patients in the observation group and the control group after 1d; 2wk; 1, 3mo(P<0.05). There was no statistical difference in intraocular pressure between the two groups. There was statistical differences between incidence of shallow anterior chamber of the patients in the observation group and the control group postoperatively early stage(P<0.05). After 6mo, the filtering bleb formation in observation group was no significantly better than control group(P>0.05).

CONCLUSION: It is safe and effective that the improved sewing method of sclera flap for trabeculectomy of acute angle-closure glaucoma, and it is a better method to avoid the occurrence of shallow anterior chamber than the traditional sewing method in the early stage after operation.

Abstract:AIM: To compare the effect of two surgical methods on neovascular glaucoma(NVG).

METHODS: The clinical date of 46 cases(57 eyes)with NVG underwent surgical treatment were retrospectively analyzed and followed-up. Patients were divided into Ahmed glaucoma valve(AGV)implantation group(group A, 24 cases, 31 eyes)and semiconductor diode laser transscleral ciliary body photocoagulation(TSCPC)group(group B, 22cases, 26 eyes)according to the surgical approach. The intraocular pressure, visual acuity and postoperative complications were compared before and after operation.

RESULTS: The intraocular pressure postoperative in two groups were significantly lower than those preoperative(P < 0.05), but there was no significant difference between the two groups(P>0.05). The changes of visual acuity postoperative showed no statistical difference between the two groups(P>0.05). The postoperative complications of group A was significantly lower than that in group B, in which the incidence of eye pain, anterior chamber bleeding were significant differences between two groups(P <0.05).

CONCLUSION: AGV implantation treatment and TSCPC for NVG are both valid, but AGV implantation is filtration surgery, and TSCPC isciliary body destructive surgery, and the latter has higher rate of postoperative complications.

Abstract:AIM: To evaluate the clinical efficacy of intravitreous injection of Lucentis combined with argon laser photocoagulation on retinal macroaneurysm.

METHODS: A retrospective observation about intravitreous injection of Lucentis combined with argon laser photocoagulation was performed on 9 patients(9 eyes)with retinal macroaneurysms with macular edema between January 2011 and July 2013. Through the collection of clinical data in patients best-corrected visual acuity, change of the retinal macroaneurysm, optical coherence tomography and fluoresce in fundus angiography before therapy and 1 mouth,3 mouths after therapy, comparative analysis the changes in best-corrected visual acuity and central macular retinal thickness(CMT)between before and after treatment.

RESULTS: Followed for more than 3 months, all patients' best-corrected visual acuity were improved obviously, the difference was significant(P<0.05); The patients' macular edema was obviously absorbed and the average CMT was significantly lower, the difference was significant(P<0.05). In fundus fluorescein angiography, the neoplasia body was atrophied inordinately after 3 months of treatment.

CONCLUSION:Intravitreous injection of Lucentis combined with argon laser photocoagulation is effective and security to improving visual acuity of retinal macroaneurysms with macular edema.

Abstract:AIM: To investigate the correlation between degenerative myopia and diabetic retinopathy(DR).

METHODS: Totally 106 cases with diabetes B were divided into the degenerative myopia group(48 cases)and the no degenerative myopia group(58 cases). Fundus examination and fluorescence fundus angiography(FFA)were performed on all cases. The occurrence and stage of DR were compared between the 2 groups.

RESULTS: The occurrence of DR of the no degenerative myopia group(93.1%)was much higher than that of the degenerative myopia group(70.8%). Only retinopathy of stageⅠor Ⅱ was observed in the degenerative myopia group without lesion in proliferating phase, while retinopathy of stageⅠto Ⅴ could be found in the no degenerative myopia group.

CONCLUSION: Degenerative myopia can prevent DR from occurrence and may be a protective factor for DR.

Abstract:AIM: To explore the relationship of MMP-9 and serum fructosamine levels and further illustrate the role of the development in diabetic retinopathy patients.

METHODS: Serum MMP-9 levels were measured using enzyme-linkedimmunosorbent assays a in 30 health controls and 30 diabetic retinopathy patients, the relationship of MMP-9 and serum fructosamine levels were analyzed。

RESULTS: Compared with healthy controls. The expression levels of MMP-9 indiabetic retinopathy patients were significantly increased \〖(8.14±2.28pmol/L), vs(2.47±1.41pmol/L)\〗, MMP-9 were positive correlation with fructosamine(r=0.94, P<0.05).

CONCLUSION:The occurrence and progress of diabetic retinopathy might be closely related to the expression level of MMP-9, and the abnormal expression of MMP-9 in patients' serum might be associated with the secretion of fructosamine.

Abstract:AIM: To evaluate the long-term results of visual outcomes and safety of phacovitrectomy with intraocular lens implantation in the treatment of complex vitreoretinal diseases.

METHODS: A retrospective analysis was performed in case series. Totally 143 eyes of 162 patients underwent phacovitrectomy and intraocular lens implantation. Main outcome measures were visual acuity and operative complications.

RESULTS: The mean follow-up was 26.2mo. The main vitreoretinal surgical indications were retinal detachment, proliferative diabetic retinopathy and macula disease. In total, 86 eyes(53.1%), 89 eyes(54.9%), 87 eyes(53.7%), 93 eyes(57.2%)and 101 eyes(62.3%)gained two or more lines of vision compared with baseline, at 1mo, 6mo, 12mo, 18mo and 24mo follow-up.

CONCLUSION:Phacovitrectomy and intraocular lens implantation is safely and effectively used for cataracts and complex vitreoretinal diseases.

Abstract:AIM:To investigate the curative effects on a modified simple removal surgery of magnetic foreign body in the anterior part of vitreous cavity combined with traumatic cataract.

METHODS: Data were collected on 13 patients with ocular penetrating and perforating injuries combined with traumatic cataracts and magnetic foreign bodies in the anterior part of the vitreous cavity who underwent a simple modified removal surgery. Under direct vision of binocular indirect ophthalmoscope, the intraocular earth magnet was applied to remove the magnetic foreign bodies after clearance of the turbid lens and prolapsed vitreous. Postsurgical intraocular reaction and recovery of the visual function were observed and evaluated.

RESULTS: Under the direct vision, by using this surgery method, all the magnetic foreign bodies were successfully removed smooth and fast. No complication such as secondary bleeding or infection occurred. Corrected visual acuity has been improved obviously in all these patients who underwent operation. The postoperative follow up of 6mo showed that the BCVA of 10 cases was >0.3. BCVA of the other 3 cases was 0.1-0.3.

CONCLUSION: Under direct vision of binocular indirect ophthalmoscope, the magnetic foreign bodies in the anterior part of vitreous cavity can be removed accurately by using intraocular earth magnet. This modified method is simple and safe. And it is a reliable surgical option for these patients.

Abstract:AIM: To study the treatment and predisposing factors of postcataract endophthalmitis after phacoemulsification operation.

METHODS: The clinical data of 8 patients(8 eyes)with postcataract endophthalmitis were analyzed retrospectively from June 2003 to June 2013. Emergent surgery(anterior chamber irrigation, vitrectomy, intravitreal injection)was performed in all patients. Aqueous fluid and vitreous purulence was taken in all patients before vitrectomy for bacterial, fungal culture and drug sensitivity test. The preoperative and postoperative visual acuity, inflammatory reaction and postoperative complications were observed.

RESULTS: All the patients were followed up for 6-12mo.The visual acuity improved significantly at l, 6mo after surgery(P<0.05). Endophthalmitis was controlled in all of eyes after surgery, and no one case had postoperative complications. Seven cases was isolated pathogens, and the main bacteria spectrum of postcataract endophthalmitis was staphylococcus epidermidis and enterococcus faecalis(D group).The two kinds of bacteria were sensitive to vancomycin. The predisposing factors included: advanced age, diabetes, chronic obstructive pulmonary disease, renal failure, tuberculosis.

CONCLUSION: For postcataract endophthalmitis, vitrectomy as early as possible could improve the prognosis and performing the surgery of vitrectomy is effective for postcataract endophthalmitis. Vancomycin is effective antibacterials.

Abstract:AIM: To discuss the application of forced traction test in surgeries for orbital blowout fracture.

METHODS: The clinical data of 28 patients with reconstructive surgeries for orbital fracture were retrospectively analyzed. All patients were treated with forced traction test before/in/after operation. The eyeball movement and diplopia were examined and recorded pre-operation, 3 and 6mo after operation, respectively.

RESULTS: Diplopia was improved in all 28 cases with forced traction test. There was significant difference between preoperative and post-operative diplopia at 3 and 6mo(P<0.05).

CONCLUSION: Forced traction test not only have a certain clinical significance in diagnosis of orbital blowout fracture, it is also an effective method in improving diplopia before/in/after operation.

Abstract:AIM: To observe the clinical effects of the excision of pterygium combined with limbal epithelial autograft with conjunctival grafting on recurrent pterygium.

METHODS: Totally 84 patients(84 eyes)with first recurrent pterygium were allocated two groups: excision pterygium with limbal epithelial autograft with conjunctival(group A, 43 cases with 43 eyes)and excision of pterygium with conjunctival autograft(group B, 41 cases with 41 eyes), the post-operative follow-up period of 12 months, we analyzed the repair time of epithelium, tear break-up time(1 month and 3 months), Schirmer l test(1 month and 3 months), corneal fluorescence staining test(1 month and 3 months), and recurrent rate.

RESULTS: The group A had a shorter repair time of epithelium and lower recurrent rate, compared with the group B, which had statistically significant difference(P<0.05), but there was no statistically significant difference in the tear break-up time, corneal fluorescence staining test and the Schirmer l test in 1 month and 3 months between the two groups(P>0.05).

CONCLUSION:Limbal epithelial autograft with conjunctival transplantation is a convenient, safe, effective method for the treatment of recurrent pterygium.

Abstract:AIM: To investigate the viability of the morphology of inferior oblique muscle observed stereoscopically using 3-dimensional CT reconstruction technique.

METHODS: This control study included of 29 cases which were clinically diagnosed with monocular congenital superior oblique palsy, examined by dimensional CT. The images of the inferior oblique muscle were reconstructed by Mimics software. 3D digital images on the basis of CT scanning data of the individuals were established. Observing the morphology of binocular inferior oblique muscle by self-controlled design, we compared the maximum transverse diameter of inferior oblique muscle of paralyzed eye with non-paralyzed one. We chose 5% as the significant level.

RESULTS: The reconstructed results of 3-dimensional CT scan showed that not all of the inferior oblique abdominal muscle of paralyzed eyes were thinner than that of the non-paralyzed eye in maximum transverse diameter of cross-sectional area. The maximum transverse diameter of inferior oblique muscle was measured. The average maximum transverse diameter of the paralyzed eye was 6.797±1.083mm and the non-paralyzed eye was 6.507±0.848mm. The maximum transverse diameter of inferior oblique muscle of paralyzed eye did not, however, differ significantly from the normal(P>0.05).

CONCLUSION: The three-dimensional CT reconstruction technology can be used for preoperative evaluation of the morphology of inferior oblique muscle.

Abstract:AIM: To analysis the diagnostic value of B-scan on various kinds of strong echo signal of ocular-perforating injury.

METHODS: Totally 176 patients(176 eyes)with ocular-perforating injury underwent B-scan ultrasound examination. We observed the B-scan imaging findings of the lens, vitreous cavity, eyeball wall and retrobulbar space.

RESULTS: All 176 patients(176 eyes)underwent B-scan ultrasound examination had strong echo. Vitreous hemorrhage was found in 146 cases, dislocation of lens in 4 cases, intraocular foreign body in 105 cases, intravitreous bubble in 1 case, retinal detachment in 34 cases, choroidal detachment in 23 cases, posterior scleral rupture in 9 cases. Every patient had two or more signs above, and had strong echo signal. All kinds of strong echo signal of the cases were summarized as follows: thick vitreous hemorrhage; intraocular foreign body; dislocation of the lens; intravitreous bubble.

CONCLUSION: Because of anterior chamber hemorrhage, cataract, vitreous hemorrhage, eyelid swelling and noncooperation of patients, we couldn't examine the posterior segment. So B-scan provides a great help to the ophthalmologist. It is very sensitive and has specific images on the detachment of retina, intraocular foreign body, posterior scleral laceration, hemorrhagic choroidal detachment. Complex perforating injury of eyeball often appears some confusing strong echo signals, but B-scan can identify those images. Thus, it is irreplaceable by other examinations.

Abstract:AIM:To evaluate the influence on intraocular pressure(IOP)of the postural change and daily activities in the early morning in suspected glaucoma patients.

METHODS:The supine and sitting IOP were measured and analyzed on 51 suspected glaucoma patients(100 eyes)with Icare rebound tonometer before and after getting up and daily activities in the early morning.

RESULTS: The mean of sitting IOP of 51 patients was 17.12±4.53mmHg, which was significantly lower than the mean of supine IOP(19.14±5.51mmHg). The mean of IOP before and after daily activity of 51 patients were 17.12±4.53mmHg and 14.44±3.90mmHg respectively, which showed significantly difference.

CONCLUSION:Postural change and daily activities can result in significant changes of IOP in suspected glaucoma patients.

Abstract:AIM:To compare the results of laser subepithelial keratomileusis(LASEK)and laser in situ keratomileusis(LASIK)for the correction of moderate myopia.

METHODS:A retrospective analysis was performed in average uncorrected visual acuity(UCVA)and refraction of 2 488 cases 4 778 eyes operated with LASEK or LASIK in our hospital, from 2005 to 2012, and followed up more than 6mo to observe the surgical effect.

RESULTS: Three days after corneal refractive surgery, average UCVA was lower and refraction was higher in LASEK group than that in LASIK group, however, these were no statistic differences between the two groups in 30d, 90d and 180d follow-up.

CONCLUSION: LASEK and LASIK seem to be similar in terms of safety and efficacy for the correction of moderate myopia.

Abstract:AIM: To evaluate the effect of rigid gas permeable contact lens(RGPCL)for high myopia with corneal astigmatism.

METHODS: Totally 72 patients(118 eyes)with high myopia with corneal astigmatism were fitted with RGPCL, and the corrected visual acuity were recorded after one month. The MPMVA(maximum plus to maximum visual acuity)were recorded by comprehensive refraction. The corrected visual acuity of RGPCL was compared with the MPMVA.

RESULTS: There were 17 eyes of 4.7(14.4%), 52 eyes of 4.8(44.1%)and 49 eyes of 4.9-5.0(41.5%)in comprehensive refraction. There were 6 eyes of 4.7(5.1%), 21 eyes of 4.8(17.8%)and 91 eyes of 4.9-5.0(77.1%)in RGPCL corrected visual acuity. RGPCL corrected visual acuity of(4.9-5.0)improved in 42 eyes(35.6%), and the difference was statistically significant.

CONCLUSION: The application of RGPCL can correct high myopia with corneal astigmatism, and has an excellent clinical result.